TX HHS Form 3681-A. Community Services Contract Application - Addendum A

The TX HHS Form 3681-A, Community Services Contract Application - Addendum A, is a crucial document for entities seeking to provide residential care or adult foster care services in Texas. This form helps solve the problem of obtaining necessary licenses and permits from the Texas Health and Human Services (HHS) department.

This addendum provides additional information required for assisted living facilities, including their legal name, doing business as (DBA), facility physical address, and licensed capacity. The form also asks about the type of assisted living facility license held, with options for residential care - non-apartment or apartment-style facilities. Key features include the calculation of private space square footage per resident, which must be at least 360 square feet if not using allocated common area.

The TX HHS Form 3681-A, Community Services Contract Application - Addendum A, should be used by entities seeking to provide residential care or adult foster care services in Texas. This form is essential for obtaining necessary licenses and permits from the Texas Health and Human Services (HHS) department. By completing this addendum, facilities can demonstrate compliance with HHS regulations and ensure a smooth application process.